Boarding Release Form Boarding Release Form Name * Name First First Last Last Email * Phone * Pet's Name * Alternate Contact Name * Name First First Last Last Phone * Emergency Contact Name Name First First Last Last Phone Food & Belongings I would like my pet fed in-house foodMy pet has their own food (If so please provide food in a sealed container with name and feeding instructions on it.) Food instructions, amount, times per day * Treat Instructions * Food Allergies * Pet Belongings * Medications Name of Medication Amount Instructions Does your dog have any past injuries, medical problems or any current conditions? Behavior Has your dog ever attended daycare or boarding? YesNo Does your pet(s) need to be separated from other pets for playing/walks: YesNo Please list any behavioral information. Ex: Aggressive over toys or food. Does your dog get along well with other dogs? Does your dog share well? Does your dog growl? YesNo Is your dog mouthy? i.e. does he/she nibble on you? YesNo Would you like your dog fed during daycare? YesNo Is your dog frightened around anything? What happens when you or somebody else tries to take food or toys from your dog? What kind of toys does your dog like? Does your dog have any obedience training? What commands does your dog know? How does your dog react to puppies? Rate your dog’s energy level “1” being very mellow and “10” being a total uncontrollable spaz. How well does your dog get along with other animals “1” being aggressive “5” really doesn’t care and “10” being excellent? Has your dog ever bit anyone? What were the circumstances? Has your dog ever jumped or climbed over a fence? How high was it? What type of fence? REGARDING TREATMENT OF MY PET(S) DURING ITS STAY: (PLEASE CHECK ONE) In the event I cannot be reached authorize up to $100 for medical treatment that a Veterinarian deems necessary, should anything arise during my pets stay -OR- up to $500 for emergency treatment that a Veterinarian deems necessary, should a life-threatening emergency arise during my pets stay. * $100 for treatment $500 for treatment Signature signature keyboard Clear Submit If you are human, leave this field blank.
